Healthcare Provider Details
I. General information
NPI: 1689506826
Provider Name (Legal Business Name): RAMANDIP GILL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 06/02/2026
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5115 DUDLEY BLVD
MCCLELLAN CA
95652-1024
US
IV. Provider business mailing address
6088 MOON RIVER WAY
ROSEVILLE CA
95747-4796
US
V. Phone/Fax
- Phone: 916-566-1600
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 171400000X |
| Taxonomy | Health & Wellness Coach |
| License Number | |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: